# Case Report: Use of submental artery perforator flap for reconstructing defects following sinonasal tumor resection

## TL;DR

This case report shows that the submental artery perforator flap is effective for reconstructing facial defects after tumor removal in the nose and sinuses.

## Contribution

The paper presents a novel application of the extended submental artery perforator flap for complex maxillofacial reconstruction.

## Key findings

- All three flaps survived without vascular issues and showed no recurrence or metastasis.
- Functional and aesthetic outcomes were favorable with no major complications.
- Patients experienced improved facial appearance and quality of life.

## Abstract

Sinonasal malignancies (SNMs) invading orbital and maxillofacial structures require complex reconstructive techniques. The submental artery perforator flap (SMAPF) provides a promising reconstructive option due to its vascular reliability and adaptability.

A retrospective study reviewed three patients treated between December 2021 and November 2022 with radical resection of sinonasal malignancies, including orbital content removal. All patients underwent immediate reconstruction using an extended-pedicle SMAPF. The flap pedicle was elongated via microsurgical dissection under 2.5× magnification. Postoperative evaluations were conducted at 1, 3, and 6 months using nasal endoscopy and CT imaging.

All flaps survived without vascular compromise. No local recurrence or distant metastasis was observed. Functional and aesthetic outcomes were favorable, with no major complications reported.

The extended pedicled SMAPF is a reliable and effective option for one-stage reconstruction of complex orbital and maxillofacial defects following sinonasal malignancy resection. It provides stable vascular support, and functional and aesthetic outcomes meet clinical expectations.

The clinical application of the extended submental artery perforator flap in the repair of maxillofacial defects.

Graphical abstract showing three cases of orbital-maxillofacial defect reconstruction using extended submental artery perforator flap. Case 1 illustrates repair of facial swelling and pain. Case 2 shows relief from exophthalmos and nasal root swelling. Case 3 depicts improvement in left eye swelling and tissue changes. Final panel highlights good facial appearance, excellent visual effects, and improved quality of life for patients.